This article covers what payer portals are, how Taiga interacts with them, and how to set up some of the most common payer portals.
What are payer portals?
Payer portals are the web portals insurance companies create to allow providers to manage their claims along with a number of other core RCM functionalities. Taiga's billing team leverages payer portals in a few key workflows to ensure your claims are adjudicated accurately.
Why is setting up payer portals important?
As a provider, you'll want to set up payer portals with all of the insurance companies you plan to submit claims to. Setting up payer portals often grants you access to the following tools and more:
Eligibility and benefit information
Claim status and adjudication details
Requesting and tracking referrals and prior authorizations
Submitting appeals
Managing providers and credentialing
EDI and EFT connections
While Taiga processes the majority of claims without human intervention, there are a few workflows where granting our team admin-level access, where possible, to your payer portals is necessary. Some of these include but are not limited to:
Completing EDI enrollments
Submitting reconsiderations or appeals for incorrectly denied claims
Checking on claim status while your organization is onboarding
Instructions to set up common portals
Availity
A variety of payers use Availity, including but not limited to Aetna, BCBS, Humana, etc.
Set up your provider portal: https://www.availity.com/essentials
How to grant Taiga admin access:
Click on your name in the top right corner
Click on Add User
Type in the following usernames:
nandaguntupalliadamwax06
Check the box that says "This is an existing user ID"
Check the boxes of all the organizations they need access to
Click on Next
Check the box next to User Administration to ensure our team has admin rights to add other members of Taiga's billing team
United Healthcare
Set up your provider portal: https://www.uhcprovider.com/en/access.html
How to grant Taiga admin access:
Click on Practice Management in the top right
Click on Manage Users
Click on the Organization that you want to add users to
Click on + Add New User(s) in the top right corner
Add the following users:
Nanda Guntupalli
First Name: Nanda
Last Name: Guntupalli
Email Address: [email protected]
Adam Wax
First Name: Adam
Last Name: Wax
Email Address: [email protected]
Set the Job Function to Administrative Staff
Click on Confirm and Submit
Cigna
Set up your provider portal: https://static.cigna.com/assets/chcp/resourceLibrary/howToRegister.html
How to grant Taiga admin access:
Once you have set up your Cigna provider portal, Taiga will request access to the TIN associated with your account.
Please approve Taiga's request by choosing: Delegate access and views. This will ensure our team has access to add other members of Taiga's billing team.
Blue Shield of CA
Set up your provider portal: https://www.blueshieldca.com/provider/account-tools/login/home.sp
How to grant Taiga admin access:
Once you have set up your Blue Shield of CA provider portal, Taiga will request access to the TIN(s) associated with your account(s).
Please approve Taiga's request — you'll receive an email when the request is sent.
Navinet
Set up your provider portal: https://navinet.secure.force.com/
How to grant Taiga admin access:
Select the Administration dropdown
Select Create New User
Add the following users:
Nanda Guntupalli
First Name: Nanda
Last Name: Guntupalli
Email Address: [email protected]
Adam Wax
First Name: Adam
Last Name: Wax
Email Address: [email protected]
Select Yes for "Create this user as a Security Officer"
Click Add User to List
Clearinghouse access policy
To maintain rigorous security and privacy protocols, Taiga is unable to grant external users access to our clearinghouse accounts. If your team requires data typically found in a clearinghouse — such as information needed to resolve claim rejections — Taiga surfaces this information directly within your dashboard:
Claim detail: each claim's detail page shows the responses received from the clearinghouse and the payer, providing the specific details needed for corrections.
Reports: for a high-level overview of billing health, use the Reports page to track collections and outstanding issues.
For all other billing follow-up tasks — including denial management, eligibility verification, and filing appeals — we recommend utilizing the specific payer provider portals. These portals remain the most comprehensive resource for direct communication and detailed adjudication status from the insurance carriers.